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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.Drg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: <br />r14 33rcL Aevnae (I; wer-r481c^ <br />PROPERTY TAX # <br />00S' I Too 3 01 30o <br />PERMIT # <br />G.I3o L1 - 06L4 <br />LEGAL for new construction: Shod Plat/subdivision <br />Lot No._ (attach copy of long legal description) <br />OWNER ScAt <br />aad Twrie 14014-- <br />Phone/E-mail 4AS- 341- 3743 <br />Address U914 33"d venikE- w <br />CilylStaterzip tverr gaj,P3 <br />APPLICANT: Owner XOvmees Agentrr,�� Contractor _Contractor's Agent Tenant fmuslprondealctttr of wnsrnteommewmtrbcowomh mespacel <br />CONTRACTOR TO- .e W S <br />L & I Lic. # COE Bus. Lic. # <br />Address 5 <br />Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />FrieJ Barer If itasoClai-es <br />Phone/E-mail 4LS-34$-3r1iS <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 4. 1So,o:r� <br />Existing Use of Building Ties JeA+i41 S(% HEAT SOURCE: <br />Proposed Use of Building YL:slatnYfa, S(K Gas_ Electric)C Other_ <br />Building type: X Single Family _ Duplex _Townhouse _ Multi -Family ,_ Commercial <br />Type of project: New X. Addition A Remodel Repair _ T.I. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (addmona/space providedon the back): <br />. -Rt6ulld 57S"St pray- . Add 7 o54 hefj4d <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn )CAlteration _Repair Type of Project: _New _AddnAlteration _Repair <br />Show Number (#) of fixtures Show Number (4) or fixtures <br />j <br />JII <br />I A/C —air handling units <br />I Toilet <br />I Forced airs stems <br />Bathtub <br />I Gas piping <br />I Lavatory (wash basin) <br />I Water heater <br />Shower <br />Gas fireplace <br />I Kitchen sink & disposal <br />I Gas range <br />I Dishwasher <br />I Clothes dryer <br />I Clothes washer <br />Range hood <br />Water heater <br />I Exhaust fan <br />I Sink (service/bar/mo )etc.) <br />I Heat pump <br />I Backflow preventer <br />Unit heater <br />I Urinal <br />Bciler <br />I Drinking Fountain <br />I Refrigeration <br />I Floor drain <br />I Woodstove <br />I Grease trap <br />I Ducting <br />I Roc. idrains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />I <br />Other: <br />I Number of Heads <br />Other: <br />I herebycently that (have read and examined this appl!ralion and knawdre same to hetwe and correct All proAsions of laws and ordnances Governing this type of workw2 be complied <br />wth Mielher specked hercm or not The granting of a permd does not presume to give authonty to violate or cancel the provision of any oGrer state of local law regulating construction <br />That 1 am augwr by the owner of this property to perform the work for which appinatbn is made and I comply with the State Contractors law 18.27 RCN and 296.200A WAC. <br />L y <br />thorizgA Agent Sig05tvre Dale (Revised 612012) <br />